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efta-01480058DOJ Data Set 10Other

EFTA01480058

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DOJ Data Set 10
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efta-01480058
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
IP. Morgan Account Suitability Supplement J. P. Morgan A. Account Information (required for JPMS Brokerage and Investment Management accounts) Title of Account: SOUTHERN TRUST COMPANY, INC Personal Accounts 0 individual 0 Community Property 0 Transfer on Death (TOO) 0 UTMA/UGMA Primary Account Owner: Number of Dependents Name of Employer ormaigni Total Net Worth excl. Owner Annual Income (S) Liquid Net Worth (5) primary residence (5) Joint Account Owner: Annual Income (11 Entity Accounts 0 Corporation 0 Partnership 0 PIC/PHC (applicable to International entitles only) 0 Sole PrIprietorship 0 Foundation 0 Endowment 0 limited liability Company 0 Limited Liability Partnership 0 Other Non Profit Annual Income (5) 5,000.000 Liquid Net worth (025,000,000 Total Net Worth (5) 30,000,000 Trust/Estate Accounts 0 Trust 0 Estate 0 Endowment 0 Foundation 0 ERISA Plan 0 Other Charitable Trust 0 Other Trust/Estate liquid Net Worth (5) Trust/Estate Total Net Worth ($) B. Affiliations (required for JPMS Brokerage and Investment Management accounts) Applicable to account owners or authorized signers or trustees and executors. I, my spouse, or immediate family member who receives material support from me or gives material support to me is, or has been, a director, corporate officer, control person, affiliate or an owner of 10% of a public corporation's stock: 0 Yes 0 No If yes, name of person Name of corporation If yes, is the corporation traded publicly on a V.S. Stock exchange? K Yes No I, my spouse, immediate family member who receives material support from me or gives material support to me, or an individual controlling the account Is employed by or associated with an FCM, broker-dealer, a futures or securities exchange, the NFA or FINRA, the CFTC, SEC or the MSRB: 0 Yes fa No If yes,• name of employer Name of employee/assoc Accountholder or immediate family member or another household member is an employee of a financial institution or insurance company: In Yes pg No If yes*, name of institution Name of employee/assoc. •If Yes, Broker-Dealer and FINRA member financial institutions must provide written permission on corporate letterhead to open a Brokerage. Margin, or Investment Management account. 0 Joint (3TWROS/JAWROS for TX residents) 0 Tenants In Common °Tenants by the Entirety 0 IRA C. Brokerage Account Information (required for JPMS Brokerage accounts only) Investment Profile My objective for this account (check one): 0 Capital Preservation 0 Income Generation 0 Capital Appreciation Speculative or aggressive investments that may anerate higher returns but may be riskier than other investments because I may lose all or part of my Investment (check one): 09 Are permitted in this account 0 Are not permitted in this account Primary source of income: 0 Investments 0 Compensation 0 Pension 0 Other Please indicate the number of years of personal trading experience for the authorized party(s) on this account: Hedge Funds/ Private A FA' rnrod Commodities_.... 10 10 1 ure° 10 Options 10 Eptlilerruguit7 10 10 VIM' 10 Stocks Dorris FX Adducts Placements " I currently have brokerage accounts with the following firms: NO Approximate value of investable assets held away from the firm? $ 1,000,000 Those assets are Invested In the following Asset Classes: ME/unties ®Fixed Income IN Cash MAlternative Investments 00ther Most of those assets are invested In: ®Equities 0 Fixed Income & Cash 0Alternative Investments 0 Other Check only one selection for Investment Time Horizon, Primary Liquidity Needs, and Secondary Liquidity Needs Investment lime Horizon: 0 Less than 1 year 0 1-5 years 0 6-10 years 18) Greater than 10 years Primary Liquidity Needs: Secondary Liquidity Needs: 0Short Tenn 0 Medium Term 0Short Term 0 Medium Term fel Long Term 0 None 0 Long Term 0 None J.P. Morgan Use Only Page 1 of 2 SOUTHERN TRUST COMPANY, INC Title SPN NELSON D JUSTIN Banker/Investor 3/13 1522 Confidential Treatment Requested by JPMorgan Chase CONFIDENTIAL JPM-SDNY-00002107 SDNY_GM_00271305 EFTA01480058

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